MANUAL MINORS
Forearm fractures affect one or both of the bones that comprise it: the radius and the ulna. These fractures typically occur due to direct trauma, falls onto an outstretched arm, or high-energy accidents. They may be isolated (involving one bone) or combined, ranging from simple fractures to comminuted fractures (bone fragmentation). Symptoms include intense pain, visible deformity, swelling, and difficulty or inability to move the forearm.
Diagnosis
Diagnosis is made through a patient’s trauma history, physical examination, and imaging studies. X-rays are the standard for confirming the type and location of the fracture. However, in complex fractures, a CT scan may be useful to plan surgical treatment.
Differential Diagnosis
Condition | Distinctive Characteristics |
|---|---|
Wrist sprain | Pain without bone deformity or loss of bone continuity on X-rays. |
Elbow dislocation | Pain and deformity in the elbow joint, not in the forearm. |
Distal radius fracture | Pain and swelling in the wrist, with the fracture located at the distal end of the radius. |
Olecranon fracture | Localised pain in the elbow, without affecting the forearm shaft. |
Emergency Management
In the emergency setting, it is crucial to immobilise the forearm to prevent further damage. A splint or sling is used to stabilise the fracture. Pain relief should be administered, and in cases of open fractures, antibiotics and tetanus prophylaxis are required. If the fracture is displaced, manual reduction under anaesthesia or sedation may be necessary before immobilisation.
Definitive Treatment
Definitive treatment depends on the type of fracture. Non-displaced fractures can be treated with immobilisation in a splint or cast for several weeks. Displaced or unstable fractures usually require surgical treatment with open reduction and internal fixation (plates, screws, or nails). Physiotherapy is essential to restore range of motion and function after immobilisation or surgery.
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